Pregnancy and CD4 count
Oct 18, 2014
Hi, So I am 3 months pregnant and HIV positive. I am taking Truvada and Issentress and I am undetectable. Before my pregnancy I had a 1000 CD4. Now after my first three months lab (my doctors are monitoring my numbers now every three months), my CD4 count is 864. At my last point, my ob asked what my ID doctor said about switching meds. I told her that he was supportive of my current regime and would change it if my viral load goes up. My ob then asked me well what if your CD4 goes down? To this I didn't have an answer, especially since I haven't thought about it that way. But then she said that I should worry about a regime change at this point since I am undetectable and because I am having twins, I have 40% more blood running through my veins and that the extra blood and plasma is the likely cause of my CD4 being diluted. So I guess my question is if my CD4 continues to decline, should I change my regime? And if so what regime do you think the doctor should put me on?
Thank you so much for your time.
Response from Dr. Young
Hello and thanks for posting. Congratulations on your pregnancy.
Your CD4 count changes are not significant. As long as your viral load remains undetectable and your CD4 count and percent remains in the normal range, there's little need to worry. Indeed, among people who have been undetectable on stable regimens with CD4s over 500, current US guidelines state that CD4 counts are optional. This means that the likelihood of any clinically meaningful decline in counts is vanishingly low.
Hope that helps and be well, BY
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